<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-price" data-rule="required" class="form-control" name="row[price]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Win_integral')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-win_integral" data-rule="required" class="form-control" name="row[win_integral]" type="number" value="0">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level1num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level1Num" data-rule="required" class="form-control" name="row[level1Num]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level2num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level2Num" data-rule="required" class="form-control" name="row[level2Num]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level3num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level3Num" data-rule="required" class="form-control" name="row[level3Num]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level1time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level1Time" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[level1Time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level2time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level2Time" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[level2Time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Level3time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-level3Time" data-rule="required" class="form-control datetimepicker" data-date-format="YYYY-MM-DD HH:mm:ss" data-use-current="true" name="row[level3Time]" type="text" value="{:date('Y-m-d H:i:s')}">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
